Ophthalmoscope mounted face shield

ABSTRACT

A visor is provided that is adapted to be mounted on a binocular indirect ophthalmoscope. The visor includes: a visor body shaped to conform with at least a portion of the binocular indirect ophthalmoscope; a visor attachment portion located between the visor body and one of a headband, instrument housing, or instrument housing strut of the binocular indirect ophthalmoscope when the visor is mounted on the binocular indirect ophthalmoscope. The visor is mountable on the binocular indirect ophthalmoscope such that the visor body is located in front of a substantial portion of a wearer of the binocular indirect ophthalmoscope. The visor is located on the binocular indirect ophthalmoscope such that the visor does not interfere with operation of the binocular indirect ophthalmoscope during operation of the binocular indirect ophthalmoscope.

CROSS-REFERENCES TO RELATED APPLICATIONS

This application claims priority to and is a non-provisional of U.S.provisional patent application Ser. No. 63/008,074 for a “Face Shieldfor Use With Binocular Indirect Ophthalmoscope” filed on Apr. 10, 2020,and claims priority to and is a non-provisional of U.S. provisionalpatent application Ser. No. 63/012,866 for a “Face Shield for Use WithBinocular Indirect Ophthalmoscope” filed on Apr. 20, 2020, the contentsof which are incorporated herein by reference in their entireties.

FIELD

This disclosure relates to the field of personal protective equipment.More particularly, this disclosure relates to a protective face shieldfor use in healthcare during patient examinations and procedures.

BACKGROUND

Face shields are a form of personal protective equipment (“PPE”) thatmay be used by healthcare workers for protection of the facial area andassociated mucus membranes (such as the eyes, nose, and mouth) from bodyfluids during patient examinations and procedures. The facial area isone of the areas most commonly contaminated by body fluids duringmedical examinations and procedures. Face shields may protect fromaerosolized pathogens and droplets or fluids containing pathogens.

Face shields may offer a number of advantages over other forms of PPEthat provide face and eye protection, such as protective facemasks,goggles, and safety glasses. Face shields may cover a larger portion ofthe face than other forms of protective equipment. Further, face shieldssuffer from less fogging than goggles or safety glasses, especially whenused in conjunction with face masks. Face shields may further providebetter protection from liquids than fiber-based face masks.

Face shields may include a visor which is formed of a transparentelement of the face shield that covers a face of a wearer of the faceshield. Visors may be manufactured from various materials, includingpolycarbonate, propionate, acetate, polyvinyl chloride, and polyethyleneterephthalate glycol. The Centers for Disease Control and preventionrecommends that visors be of sufficient width to reach a front of awearer's ear and of sufficient height to provide crown and chinprotection for improved infection control purposes. The visor may besupported by a frame or suspension system to support the visor in frontof the face. In some configurations, face shield visors are attached toa superior aspect of a face mask, as shown in FIG. 1. Other face shieldsmay utilize eyeglass-type temple bars to support the visor, as shown inFIG. 2. In another configuration, a headband that partially or fullyencircles a wearer's head may be used to support the visor, as shown inFIG. 3.

A binocular indirect ophthalmoscope is a medical instrument used byhealthcare providers, such as optometrists and ophthalmologists, toexamine and visualize a patient's eye, such as internal portions of theeye such as the retina or optic nerve. Referring to FIG. 4, thebinocular ophthalmoscope may include an instrument, a headband tosupport the instrument, and an adjustable connecting mechanism/strutbetween an instrument housing and the headband. Components of theinstrument may include a light source, an optical system includingeyepieces, lenses, mirrors, prisms, a viewing or illumination frontwindow, a number of levers, dials, and switches to adjust theinstrument, and a housing containing and supporting components of theinstrument.

To examine a patient's eyes or perform a procedure or surgery on apatient's eyes, a healthcare provider first dons the binocular indirectophthalmoscope on their head using a headband to support the instrumentin front of their eyes. The adjustable mechanism/strut between theinstrument housing and the headband may be used to properly angle theinstrument, as shown in FIG. 5. The light source is illuminated and thelight is shown on the patient's eye using a hand-held condensing lens.The healthcare provider then views the patient's eye using theinstrument's optical system. When using a binocular indirectophthalmoscope, the healthcare provider must keep their face in closeproximity to the patient to adequately examine the eye or perform aprocedure or surgery on the eye. The healthcare provider's face, eyes,and mucus membranes are thereafter subject to aerosol or dropletcontamination from a patient's mouth during an examination, procedure,or surgery.

A number of difficulties are created when attempting to use existingface shields with a binocular indirect ophthalmoscope. If the visor ofthe face shield is affixed to a face mask or if the visor of the faceshield is supported by eyeglass-type temple bars, the superior aspect ofthe face shield will abut the connecting mechanism/strut, the headband,or the instrument housing of the binocular indirect ophthalmoscope,thereby preventing proper positioning of the binocular indirectophthalmoscope and preventing proper positioning of the face shield orface mask. Further, if the visor of the face shield is supported by aheadband, the headband of the face shield will interfere with theheadband of the binocular indirect ophthalmoscope or vice versa. Afurther difficulty in using an existing face shield is that the housingof the binocular indirect ophthalmoscope precludes proper placement ofthe visor of headband-supported face shields. Another difficulty is thatcurrent face shield visors placed between the healthcare provider's faceand the binocular indirect ophthalmoscope are often uncomfortablycompressed against the healthcare provider's nose, mouth, and if usedsimultaneously, face mask. Yet another difficulty is that current faceshield visors placed in front of or behind binocular indirectophthalmoscopes often cause glare or light reflections which impair theuser's ability to examine the eye. Finally, current face shields oftensuffer from fogging due to condensation from breathing, sweating, orambient humidity.

What is needed, therefore, is a binocular indirect ophthalmoscopemounted face shield that overcomes the above and other difficultiesassociated with using traditional PPE with a binocular indirectophthalmoscope.

SUMMARY

The above and other needs are met by a binocular indirect ophthalmoscopemounted face shield. In a first aspect, visor adapted to be mounted on abinocular indirect ophthalmoscope includes: a visor body, wherein aportion of the visor body is shaped to conform with at least a portionof the binocular indirect ophthalmoscope; a visor attachment portion,the visor attachment portion located between the visor body and one of aheadband, instrument housing, or instrument housing strut of thebinocular indirect ophthalmoscope when the visor is mounted on thebinocular indirect ophthalmoscope. The visor is mountable on thebinocular indirect ophthalmoscope such that the visor body is located infront of a substantial portion of a wearer of the binocular indirectophthalmoscope. The visor is located on the binocular indirectophthalmoscope such that the visor does not interfere with operation ofthe binocular indirect ophthalmoscope during operation of the binocularindirect ophthalmoscope.

In one embodiment, the visor is movably mounted on one of the headband,instrument housing, and strut of the binocular indirect ophthalmoscope;and the visor is movable between a raised position and a loweredposition. In another embodiment, the visor is pivotally mountable on theheadband binocular indirect ophthalmoscope. In yet another embodiment,the visor is pivotally mountable on the instrument housing of thebinocular indirect ophthalmoscope. In one embodiment, when the visor isin the raised position the binocular indirect ophthalmoscope ismountable on a wall charger.

In another embodiment, the visor attachment portion includes one or moresupport members, wherein the one or more support members support thevisor such that the visor is spaced-apart from the binocular indirectophthalmoscope.

In yet another embodiment, the visor is mounted on the instrumenthousing of the binocular indirect ophthalmoscope and the visorattachment portion includes one or more of an adhesive or fasteners. Inone embodiment, the visor is mounted on the headband of the binocularindirect ophthalmoscope and the visor attachment portion includes one ormore of an adhesive or fasteners.

In another embodiment, the visor is mounted on the binocular indirectophthalmoscope such that the body is located flush against anillumination window of the instrument housing. In yet anotherembodiment, the visor is mounted on the binocular indirectophthalmoscope such that the body is located flush against an eyepieceof the instrument housing.

In one embodiment, the visor further includes a cutout located at theinstrument housing such that the visor fits at least partially aroundthe instrument housing of the binocular indirect ophthalmoscope.

In a second aspect, a visor adapted to be mounted on a binocularindirect ophthalmoscope includes: a visor body shaped to conform with atleast a portion of the binocular indirect ophthalmoscope; a visorattachment portion located between the visor body and one of a headband,instrument housing, or instrument housing strut of the binocularindirect ophthalmoscope when the visor is mounted on the binocularindirect ophthalmoscope. The visor is movably mountable on the binocularindirect ophthalmoscope such that the visor body is located in front ofa substantial portion of a wearer of the binocular indirectophthalmoscope when the visor is in a lowered position. The visor islocated substantially above the binocular indirect ophthalmoscope whenthe visor is in a raised position. The visor is located on the binocularindirect ophthalmoscope such that the visor does not interfere withoperation of the binocular indirect ophthalmoscope during operation ofthe binocular indirect ophthalmoscope when the visor is in the raisedand lowered positions.

BRIEF DESCRIPTION OF THE DRAWINGS

Further features, aspects, and advantages of the present disclosure willbecome better understood by reference to the following detaileddescription, appended claims, and accompanying figures, wherein elementsare not to scale so as to more clearly show the details, wherein likereference numbers indicate like elements throughout the several views,and wherein:

FIG. 1 shows a front view of an existing face mask with a face shield;

FIG. 2 shows a perspective view of an existing face shield;

FIG. 3 shows a perspective side view of an existing face shield;

FIG. 4 shows a side view of a binocular indirect ophthalmoscope;

FIG. 5 shows a healthcare provider wearing a binocular indirectophthalmoscope;

FIG. 6 shows a top perspective view of a visor mounted on a binocularindirect ophthalmoscope according to one embodiment of the presentdisclosure;

FIG. 7 shows a side view of a visor mounted on a binocular indirectophthalmoscope according to one embodiment of the present disclosure;

FIG. 8 shows a side view of a visor mounted on a binocular indirectophthalmoscope with the visor in a raised position according to oneembodiment of the present disclosure; and

FIG. 9 shows a side view of a visor mounted on a binocular indirectophthalmoscope during charging of the binocular indirect ophthalmoscopeaccording to one embodiment of the present disclosure.

DETAILED DESCRIPTION

Various terms used herein are intended to have particular meanings. Someof these terms are defined below for the purpose of clarity. Thedefinitions given below are meant to cover all forms of the words beingdefined (e.g., singular, plural, present tense, past tense). If thedefinition of any term below diverges from the commonly understoodand/or dictionary definition of such term, the definitions belowcontrol.

FIG. 6 shows a basic embodiment of a visor 10 mounted on a binocularindirect ophthalmoscope 12. The visor 10 is mounted on the binocularindirect ophthalmoscope 12 such that the visor 10 substantially protectsa face of a healthcare provider wearing the binocular indirectophthalmoscope 12 and is mounted such that the visor 10 does notinterfere with use of the binocular indirect ophthalmoscope 12, such asduring examination of a patient or during a procedure.

The visor 10 may be bonded or otherwise permanently fixed to aninstrument housing 14 of the binocular indirect ophthalmoscope 12.Alternatively, the visor 10 may be located on or form part of anextension of the instrument housing 14. In one embodiment the visor 10may be located on the instrument housing 14 such that the visor 10 islocated in front of the instrument housing 14. Alternatively, the visor10 may be mounted on the instrument housing 14 such that the visor 10 islocated behind the instrument housing 14 towards the face of ahealthcare provider wearing the binocular indirect ophthalmoscope 12.

In one example, the visor 10 may be secured to the instrument housing 14on opposing sides of an illumination window 15 of the instrument housing14. The visor 10 may be secured, for example, with adhesive strips 16located between the visor 10 and the instrument housing 14. The adhesivestrips 16 or other fasteners used are preferably located on either sideof the illumination window 15 such that the illumination window 15 ofthe binocular indirect ophthalmoscope 12 is not obstructed.

In another embodiment, the visor 10 is removably secured on thebinocular indirect ophthalmoscope 12, such as on the instrument housing14. For example, the visor may be removably secured on the instrumenthousing 14 using one or more of screws, clips, adhesives, hook and loopfasteners, buttons, snaps, pegs, or sleeves. The visor 10 may beremovably secured either in front of the instrument housing 14 or behindthe instrument housing 14 of the binocular indirect ophthalmoscope 10.

In one embodiment, the visor 10 is secured on the binocular indirectophthalmoscope 12 on a headband 18 of the binocular indirectophthalmoscope 12. The visor 10 may be permanently or removably securedto the headband 16. For example, the visor 10 may be removably securedon the headband 18 using one or more of screws, clips, adhesives, hookand loop fasteners, buttons, snaps, pegs, or sleeves. The visor 10 maybe removably secured either in front of the instrument housing 14 orbehind the instrument housing 14 of the binocular indirectophthalmoscope 10.

In yet another embodiment, the visor 10 may be secured on the binocularindirect ophthalmoscope at a strut 20 or other mechanism connecting theinstrument housing 14 to the headband 18. The visor 10 may bepermanently bonded or mounted to the strut 20 between the instrumenthousing 14 and the headband 18 of the binocular indirect ophthalmoscope12. Alternatively, the visor 10 may be removably mounted to the strut20. For example, the visor 10 may be removably secured on the strut 20using one or more of screws, clips, adhesives, hook and loop fasteners,buttons, snaps, pegs, or sleeves. The visor 10 may be removably securedeither in front of the instrument housing 14 or behind the instrumenthousing 14 of the binocular indirect ophthalmoscope 10 when the visor 10is mounted on the strut 20.

The visor 10 may be mounted on the binocular indirect ophthalmoscope 12using one or more clips or other mechanisms of securing the visor 10 toone of the instrument housing 14, headband 18, or strut 20. For example,a clip or other mechanism for connecting the visor 10 to the binocularindirect ophthalmoscope 12 may be used to secure the visor 10 in frontof a face of a wearer of the binocular indirect ophthalmoscope 12. Inone embodiment, the visor 10 may be formed in a shape that is adaptableto a plurality of types of the binocular indirect ophthalmoscope 12,such as using one or more clips or other attachment mechanisms.

The visor 10 may be mounted on the binocular indirect ophthalmoscope 12such that the visor 10 is flush with the illumination window 15 of thebinocular indirect ophthalmoscope 12. Alternatively, the visor 10 may bemounted on the binocular indirect ophthalmoscope 12 such that the visor10 is flush with eyepieces 22 of the binocular indirect ophthalmoscope12. In another alternative, the visor 10 may be spaced apart from theillumination window 15 or the eyepieces 22 of the binocular indirectophthalmoscope 12 such that a gap exists between the visor 10 and one ofthe illumination window 15 and the eyepieces 22 and the visor 10.

The visor 10 may be formed having a visor body 24. The visor body 24 maybe substantially flat. Alternatively, the visor body 24 may be curvedsuch that a shape of the visor 10 conforms around a shape of a head of ahealthcare provider wearing the visor 10 and the binocular indirectophthalmoscope 12. The visor body 24 may be placed in front of theillumination window 15 or behind the eyepieces 22. Alternatively, acutout or hole may be formed through the visor body 24 at theillumination window 15 or the eyepieces 22 such that the visor body 24is not located within a field of view of the binocular indirectophthalmoscope 12.

The visor body 24 may be contoured or otherwise shaped to conform to ashape of the binocular indirect ophthalmoscope 12. For example, thevisor body 24 may be contoured to conform to a shape of one or more ofthe instrument housing 14, the headband 18, or the strut 20 of thebinocular indirect ophthalmoscope 12. The visor body 24 may be securedon the binocular indirect ophthalmoscope 12 at one or more switches ordials 26 of the binocular indirect ophthalmoscope 12. In one embodiment,the visor 10 is secured on the binocular indirect ophthalmoscope 12 suchthat the visor 10 angles away from a face of a wearer of the binocularindirect ophthalmoscope 12 to create additional space for the healthcareprovider to breathe.

The visor 10 may be fixed in position relative to the binocular indirectophthalmoscope 12. Alternatively, the visor 10 may be secured on thebinocular indirect ophthalmoscope 12 such that the visor 10 may pivotbetween a raised position (FIG. 8) and a lowered position (FIG. 7). Inthe raised position, the visor 10 is located such that the visor body 24is not over a face of the healthcare provider. In the lowered position,the visor body 24 is located proximate to the face of the healthcareprovider to substantially protect the face of the healthcare provider.The visor 10 may be secured on the binocular indirect ophthalmoscope 12at a pivot, such as with one or more axles, ball and socket joints,hinges, or other suitable components for allowing the visor 10 to pivotwith respect to the binocular indirect ophthalmoscope 12. In oneembodiment, the visor 10 is pivotally mounted on the binocular indirectophthalmoscope 12 with one or more support members 28 such that thevisor 10 is spaced-apart from the binocular indirect ophthalmoscope 12.The one or more support members 28 may be pivotally mounted on thebinocular indirect ophthalmoscope 12 to allow the visor 10 to pivotbetween the raised and lowered positions. When the visor 10 is in theraised position, the visor 10 is oriented relative to the binocularindirect ophthalmoscope 12 such that the binocular indirectophthalmoscope 12 may be placed on a charger 30 or hanging from a wall,as shown in FIG. 9.

In operation, a healthcare provider may don the binocular indirectophthalmoscope 12 having the visor 10 secured thereon on the healthcareprovider's head, using the headband 18 to support the instrument housing14 and instruments contained therein in front of the wearer's eyes. Thehealthcare provider may adjust a position of the instrument housing 14to a suitable location in front of the wearer's face, as shown in FIG.7. A light source is illuminated and shines light on an eye of a patientusing a handheld condensing lens. The healthcare provider then views thepatient's eye using the binocular indirect ophthalmoscope whileperforming an examination, procedure, or surgery. The visor 10 protectsa face and head of the wearer of the binocular indirect ophthalmoscopewhile providing a clear view through the visor 10. The visor 10 may berotated or otherwise moved to the raised position (FIG. 8) while thevisor 10 is not in use or not needed, or while the binocular indirectophthalmoscope 12 is resting on the charger 30 (FIG. 9).

By securing the visor 10 to the binocular indirect ophthalmoscope 12according to embodiments described herein, various problems are solved.First, the visor 10 may be properly positioned relative to the strut 20,the instrument housing 14, the headband 18, or other components of thebinocular indirect ophthalmoscope 12 without interfering with thosecomponents, thereby allowing proper positioning of both the visor 10 andcomponents of the binocular indirect ophthalmoscope 12. Second, bysecuring the visor 10 on the binocular indirect ophthalmoscope 12, aseparate headband for the visor 10 or other means of supporting thevisor 10 on the healthcare provider's head is eliminated such that nointerference exists between a support of the visor 10 and the binocularindirect ophthalmoscope 12. Third, the visor 10 may be placed in anappropriate position over the face of the healthcare provider withoutcausing any deflection of the visor 10 from the instrument housing 14 orother components of the binocular indirect ophthalmoscope 12. Fourth,embodiments of the visor 10 described herein will not cause the visor 10to be pressed uncomfortably against a nose, mouth, or face of thewearer, and will not prevent the use of a facemask being worn by thehealthcare provider. Fifth, any glare or light reflections from thevisor may be reduced or eliminated by providing a controlled distanceand angle between the visor and binocular indirect ophthalmoscope 12illumination or illumination window 15. Sixth, by locating the visor 10on the binocular indirect ophthalmoscope 12 as disclosed herein,adequate space for air flow between the wearer's face and the visor 10is provided to reduce or eliminate fogging due to condensation frombreathing, sweating, or ambient humidity. Seventh, by allowing the visor10 to move between raised and lowered positions relative to thebinocular indirect ophthalmoscope 12, the healthcare provider may movethe visor 10 out of a field of view of the healthcare provider when thevisor 10 is not needed. Eighth, allowing the visor 10 to pivot betweenraised and lowered positions further allows the binocular indirectophthalmoscope 12 to be used with a wall-mounted charger or holderwithout the visor 10 contacting the wall or otherwise obstructing thebinocular indirect ophthalmoscope 12 from being located on thewall-mounted charger or holder.

The foregoing description of preferred embodiments of the presentdisclosure has been presented for purposes of illustration anddescription. The described preferred embodiments are not intended to beexhaustive or to limit the scope of the disclosure to the preciseform(s) disclosed. Obvious modifications or variations are possible inlight of the above teachings. The embodiments are chosen and describedin an effort to provide the best illustrations of the principles of thedisclosure and its practical application, and to thereby enable one ofordinary skill in the art to utilize the concepts revealed in thedisclosure in various embodiments and with various modifications as aresuited to the particular use contemplated. All such modifications andvariations are within the scope of the disclosure as determined by theappended claims when interpreted in accordance with the breadth to whichthey are fairly, legally, and equitably entitled.

What is claimed is:
 1. A visor adapted to be mounted on a binocularindirect ophthalmoscope, the visor comprising: a visor body; a visorattachment portion, the visor attachment portion located between thevisor body and one of a headband, instrument housing, or instrumenthousing strut of the binocular indirect ophthalmoscope when the visor ismounted on the binocular indirect ophthalmoscope; wherein the visor ismountable on the binocular indirect ophthalmoscope such that the visorbody is located in front of a substantial portion of a wearer of thebinocular indirect ophthalmoscope; and wherein the visor is located onthe binocular indirect ophthalmoscope such that the visor does notinterfere with operation of the binocular indirect ophthalmoscope duringoperation of the binocular indirect ophthalmoscope.
 2. The visor ofclaim 1: wherein the visor is movably mounted on one of the headband,instrument housing, and strut of the binocular indirect ophthalmoscope;and wherein the visor movable between a raised position and a loweredposition.
 3. The visor of claim 2, wherein the visor is pivotallymountable on the headband of the binocular indirect ophthalmoscope. 4.The visor of claim 2, wherein the visor is pivotally mountable on theinstrument housing of the binocular indirect ophthalmoscope.
 5. Thevisor of claim 2, wherein the visor is pivotally mountable on the strutof the binocular indirect ophthalmoscope.
 6. The visor of claim 2,wherein when the visor is in the raised position the binocular indirectophthalmoscope is mountable on a wall charger.
 7. The visor of claim 2,wherein the visor attachment portion comprises one or more supportmembers, wherein the one or more support members support the visor suchthat the visor is spaced-apart from the binocular indirectophthalmoscope.
 8. The visor of claim 1, wherein the visor is mounted onthe instrument housing of the binocular indirect ophthalmoscope andwherein the visor attachment portion includes one or more of an adhesiveor fasteners.
 9. The visor of claim 1, wherein the visor is mounted onthe headband of the binocular indirect ophthalmoscope and wherein thevisor attachment portion includes one or more of an adhesive orfasteners.
 10. The visor of claim 1, wherein the visor is mounted on thestrut of the binocular indirect ophthalmoscope and wherein the visorattachment portion includes one or more of an adhesive or fasteners. 11.The visor of claim 1, wherein when the visor is mounted on the binocularindirect ophthalmoscope the body is located flush against anillumination window of the instrument housing.
 12. The visor of claim 1,wherein when the visor is mounted on the binocular indirectophthalmoscope the body is located flush against an eyepiece of theinstrument housing.
 13. The visor of claim 1, the visor furtherincluding a cutout located at the instrument housing such that the visorfits at least partially around the instrument housing of the binocularindirect ophthalmoscope.
 14. A visor adapted to be mounted on abinocular indirect ophthalmoscope, the visor comprising: a visor body; avisor attachment portion, the visor attachment portion located betweenthe visor body and one of a headband, instrument housing, or instrumenthousing strut of the binocular indirect ophthalmoscope when the visor ismounted on the binocular indirect ophthalmoscope; wherein the visor ismovably mountable on the binocular indirect ophthalmoscope such that thevisor body is located in front of a substantial portion of a wearer ofthe binocular indirect ophthalmoscope when the visor is in a loweredposition; wherein the visor is located substantially above the binocularindirect ophthalmoscope when the visor is in a raised position; andwherein the visor is located on the binocular indirect ophthalmoscopesuch that the visor does not interfere with operation of the binocularindirect ophthalmoscope during operation of the binocular indirectophthalmoscope when the visor is in the raised and lowered positions.15. A visor adapted to be mounted on a binocular indirectophthalmoscope, the visor comprising: a visor body; a visor attachmentportion, the visor attachment portion located between the visor body andone of a headband, instrument housing, or instrument housing strut ofthe binocular indirect ophthalmoscope when the visor is mounted on thebinocular indirect ophthalmoscope; wherein the visor is movablymountable on the binocular indirect ophthalmoscope such that the visorbody is located in front of a substantial portion of a wearer of thebinocular indirect ophthalmoscope when the visor is in a loweredposition; wherein the visor is located substantially above the binocularindirect ophthalmoscope when the visor is in a raised position; whereinwhen the visor is mounted on the binocular indirect ophthalmoscope thebody is located flush against an illumination window of the instrumenthousing; and wherein the visor is located on the binocular indirectophthalmoscope such that the visor does not interfere with operation ofthe binocular indirect ophthalmoscope during operation of the binocularindirect ophthalmoscope when the visor is in the raised and loweredpositions.